My work as a counsellor in end of life care means I get to meet some truly remarkable people. Recently I was introduced to a man I will call F. He is about forty-five years old and is living with, and dying from, a neurological disease. We spoke about a range of things in our short times together. There is one thing, however, that stands out in my thoughts. At one point I mentioned to him about his wisdom, and he brushed this aside, of course, as do many people. I saw the wisdom shining out of his man.

I speak to people about values – what is worthy or important to you, what guides your life, what do you wish to stand for, and when you've gone, what do you want people to most remember you for.

For F it was all about contribution. We got around to this notion in our first conversation. Contribution is the ability to contribute, help, assist, or make a positive difference to ourselves or to others. But for F this value had been damaged somewhat by his lack of physical ability. "How can I contribute now?", he asked with a painful expression in his face.

For so many of us our sense of worth, our belief in ourselves as good human beings, rests on this ability to positively influence other people. I help others and so I am good, would be the standard line. For so many people in our society, however, because of a range of reasons they are unable to contribute in the sense that we would normally understand. For sick people, or those who are dying, or those isolated and frail, this sense of contribution, and therefore worthiness, is compromised and so often these people then sit in a pool of unworthiness, drowning, and even dying with these thoughts still occupying their minds. Add to this the sense that 'dying is failing' means that people might take their last breath thinking that they are nothing, or worthless – basically judging themselves as a 'waste of space'.

So back to F … well he and I came to a new insight which we decided to call Subtle Contribution. What this entails is the stationary, sedentary, silent, and small ways that we can continue to contribute, whilst physically unable. Can you imagine what this might entail? For F he was learning to be a person who remained in the present moment as much as he could, tried not to get caught up in unhelpful thoughts, held a sense of gratitude for each day, and developed a kind and compassionate relationship with himself. By learning to live this way he was showing a way of being which added up to a peaceful and kind human being. He had worked on his tendencies to get frustrated and taking it out on others – in other words, being responsible for his reactions and miseries. And this was a man that certainly had good reason to be grumpy and miserable – he experienced frailty and fatigue, changed cognition and high levels of pain. In living this way he was a role model to his kids – "I want them to see that this is possible" – this was his subtle contribution.

Maybe our human contribution can be simply about not pouring out our misery and complaints onto others around us. Maybe it might be more about learning how to reign in our reactions towards others. Maybe a better concept for evaluating ourselves is 'how much am I refraining from harming others today?" At the same time we can add to this "how can I cultivate attitudes and actions that stem from a place of trust, love, compassion and gratitude?" – just in each moment – and then quietly and subtly share that around you.

Our contributions to the world of others, whilst we live this precious life, don't need to be so grand. And it certainly doesn't have to be about any lofty status or how much you earn.

How might you offer subtle contributions today and if you are not what is preventing you?